I couldn’t quite believe what I was hearing! It was such a great moment for Sambani, and he was so honest. I met Sambani two days before, indeed depressed and sad. Dr Ute Wiehler has operated his first eye, and I did his second cataract operation two days later. All went well, even better than anticipated! I now saw him playing skittles with Coke bottle tops in the eye hospital courtyard with another boy who was staying in the hospital with his mother.

Sambani is from Kalonga Village in Lilongwe District. He lives with his parents and four siblings. He had been blind for two years, and had stopped going to school last year. He had been doing well at school, and told me “I was an intelligent boy!” He was in standard 4 but his low vision “made me to be a useless boy” he said. I couldn’t believe what he was saying.

Sambani in the Clinic

He lives with his father and mother and four siblings, and they were looking after him.

Sambani after his second cataract operation

Sambani told me and nurse Rose, that he is now going to continue his education because he is “still young”. He wants to be a driver or a teacher.

Sambani

It will be great to take Sambani back home today, so he can be with his whole family again, and then start school again next week when school opens for the new year. We will try and meet him again in a few months to see how he is doing.

Pieter, the South African missionary living near Monkey Bay phoned me yesterday. There are many people he has met in the villages who would like to, or need to, come to Nkhoma for their eyes. Lumbani will be heading down on Sunday with the ambulance to help collect them. We will try and meet with Mary who lives nearby, and see how she is doing, 4 months after her surgery!

Mary is young and had been at school until just over a year ago. Now she is totally blind. The brittle undiagnosed Diabetes had metabolically robbed her of her sight in a matter of months. Her sugar was so high when she came to Nkhoma, we had to spend 2 weeks controlling it even before it was safe to think of operating.

Mary with white diabetic cataracts - Photo: Roger Loguarro

With the help of the doctors in the general hospital, she did extremely well. She felt much better, less tired, but was still blind. Eventually after 12 days it was her time for surgery.

I felt very sorry for Mary, as she is so young and was doing well at school until relatively quickly her sight was lost. She can barely move around now, and constantly needs help. Of course school has been out of the question for her for the past year.

I don’t really see that many people with Diabetes in Malawi.

Meeting Mary on the waiting line

I was a bit scared when operating, as I wan’t sure how far advanced the diabetes in the eye was, but after the first operation all was well.

Half way there, and happy

In the end a small miracle happened. I was scared that the diabetes had not only resulted in cataracts, but had also affected the retina. The surgery went very well, the Nkhoma team were awesome in their care, and Mary’s sight was totally restored. I will try and visit her in her village near the south Lake Malawi lakeshore later this year, and we are helping her with her diabetic medications so she should be back at the hospital in a month or so for a check up as well.

I felt so thankful that Mary had found us, and we’d been able to help. I really hope that her life carries on in the way she planned. She was so excited to head home and celebrate.

Mary, ready to take go home to Lake Malawi, 3 hours drive away

I said goodbye to Mary on a Tuesday, and she travelled home with the Nkhoma ambulance early the next morning. I’ll tell you, and I am so happy for her!

So an awesome week, an historic week, and a lot of fun with a few very happy patients!

Nkhoma now has a modern ‘phaco’ cataract surgery service! The first permanent such unit in Malawi. Fantastic.

Although the technique we use for cataract surgery for thousands of operations each year is very very good, and we can perform an operation to treat blindness in 7-8 minutes; the availability of ‘phaco’ allows for a much smaller incision in the eye, and a faster visual recovery. Also less astigmatism (and need for glasses) and glare after surgery. Some of the really good artificial lenses we can use, have a built in UV filter to protect the retina from the sun! Which is nice.

In the end, I am so happy to have had the chance to bring ‘phaco’ to rural Malawi. And the big thing is we will now have the chance to earn a little money for the hospital, in order to continue to go into more villages and screen people with blindness, which is great. It is thanks to CBM supporters that this initiative was even possible.

After 18 months of planning, redrafting the plan, seeking advice(from the clinical and business side of things), getting the equipment and consumables together; we are here! Eesh, it was kind of a long haul, but very much worth it.

Newspaper Article

We had a bit opening ceremony at Nkhoma last Tuesday with singing and dancing and drums and speeches. Very colourful and attracted a big crowd.

Sometimes in the work here, I am called to do things not directly involving seeing people and treating blindness. I love the job that I am actually here to do, but there are unavoidable and necessary distractions sometimes.

We have spent much of the past months preparing and renovating for the new year. We will start modern cataract surgeries next week, and theatre is ready for that and many patients that will be coming to Nkhoma this year.

I had to join the Ministry of Health for planning workshops over the past weeks. The National Eye Care Plan for 2011 to 2016. Wonderful to be involved in where the country is heading for eye care.

Of course then there were many other planning meetings and report writing tasks for this coming year, and summarising 2010.

Now we are ready to tackle the new year!

With only 7 ophthalmologists for the country, we are sometimes called upon to perform extra duties. That is a normal part of the work.

One such duty was Bella.

up close with Bella

Bella

Bella is a beautiful one-eyed lioness in Lilongwe. She had had a cataract operation in the UK on her right eye, and was having some troubles with that eye for the past couple of years. As they had to anaesthetise her for another issue, they called me to see if I could come along and take a look at the same time.

Tikale had a traumatic cataract in his right eye. He was trying to get through some bushes to cross a road, when one snapped back and caught him strongly in the eye. Within a week his vision clouded over, and by the time a month later when he made it to the hospital he was blind in that eye.

Tikale just after surgery

We operated and successfully implanted an artificial lens. Tikale stayed with us in the hospital for nearly two weeks after surgery, so we could get all the drops in his eye, and check his vision regularly.

Already happy after surgery

He enjoyed hanging out at the hospital, and made a lot of friends as he was so full of renewed energy!

Tikale gettings ready to go home after surgery

On the same day a team went out to visit the villages, and drop off Tikale and his family, Sam spotted an elephant youth.

Baby elephant in the village

There used to be families of elephants roaming the Linthipe valley near Nkhoma even as recent as 25 years ago. They have all moved on now.

We are blessed that there are still one or two around!

From the team at Nkhoma and on behalf of all the patients we serve, I wish you all a very Merry Christmas and all the best for 2011!